Provider Demographics
NPI:1922826940
Name:HOERR, KATELYN (RDN, LD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HOERR
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 RANDOLPH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2161
Mailing Address - Country:US
Mailing Address - Phone:612-396-5508
Mailing Address - Fax:
Practice Address - Street 1:3808 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1304
Practice Address - Country:US
Practice Address - Phone:612-822-7946
Practice Address - Fax:612-822-9668
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5386133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered